Medical services & health care

Ensuring your safety on mountain Kilimanjaro involves acknowledging the potential hazards and implementing strategies to minimize them. To this end, we request that all climbers complete a thorough medical questionnaire. In instances where a climber has a pre-existing medical condition, we may require a doctor’s verification that they are physically capable of undertaking the climb. Your guide will also need to be aware of any medication you are currently taking, including over-the-counter products, as well as whether you are using Diamox to aid in altitude adjustment.

It’s essential to have confidence in your guide’s ability to identify the initial symptoms of altitude sickness and take appropriate measures. That’s why we prioritize ensuring our guides are adequately trained. Our guides undergo Wilderness First Responder training, which equips them with crucial skills for managing medical conditions in remote environments.

Our primary objective is to guarantee a secure and triumphant climb for all. With a guide to climber ratio of 1 to 2, we ensure that every two climbers are accompanied by a proficient mountain guide. This arrangement enables us to carefully monitor and assess the group’s well-being.

Maintaining open communication with your guide is crucial. If you’re experiencing symptoms such as headaches, nausea, or general malaise, it’s essential to inform your guide promptly. During your hike, your guide will be vigilant in watching for early indications of distress, such as stumbling, extreme fatigue, or shortness of breath. They’ll also monitor your eating habits, ensuring you’re getting enough sustenance, and encourage adequate water intake. Additionally, any erratic behavior or confusion should be reported to your guide.

Our team is also equipped with a comprehensive medical kit that includes bottled oxygen and a portable stretcher for emergency situations. The supplemental oxygen we carry is strictly for emergency use only. Acute mountain sickness can only be cured by quickly descending to a lower elevation. If a climber is unable to descend on foot due to an injury, we utilize a portable stretcher that is provided by the National Park at each campsite. In combination with immediate descent, oxygen can be administered to alleviate AMS symptoms. Moreover, we also carry a first aid medical kit to address minor injuries.

Should an emergency arise, we rely on a search and rescue service based in Moshi. After receiving a distress call, a helicopter will be dispatched to the closest landing point, and the patient can be airlifted to the local hospital. However, it’s important to note that in unfavorable mountain weather, a helicopter may not be able to land. In such cases, a manual evacuation via a stretcher provided by the National Park will be necessary.

Altitude Sickness

Altitude sickness are a mix of disorders caused by the body’s inability to adjust to elevations at or above approximately 1870m/6000ft above sea level. Increasing elevation reduces atmospheric pressure, which in turn reduces the number of oxygen molecules available for each breath . It is a common condition that can affect climbers at high elevations. Mount Kilimanjaro, the tallest peak in Africa, is no exception. Altitude sickness has three main forms: Acute Mountain Sickness (AMS), High Altitude Cerebral Edema (HACE), and High Altitude Pulmonary Edema (HAPE). It is important to recognize the symptoms of altitude sickness, as prompt treatment is necessary to prevent the condition from worsening.

Prevention of altitude sickness

• Maintain hydration despite a lack of thirst
• Maintain nutrition despite a luck of appetite
• Climb high and sleep low, this is allows more time for acclimatization
• Ascend gradually. A maximum gain of 500m/1500ft per day.
• Consider diamox 125mg up to twice daily
• Acute Mountain Sickness (AMS)
• AMS is the mildest form of altitude sickness and can affect anyone above 1870m/ 6,000ft. The initial sign is usually a headache, which can also be a sign of dehydration or over-exertion. If other symptoms develop, then a diagnosis of AMS is probable. In its mildest form, symptoms can resemble those of a hangover, with nausea, headache, fatigue, and a loss of appetite. Mild symptoms can often be resolved with rest and adequate hydration.

Moderate signs and symptoms of AMS

If the symptoms of mild AMS start to get worse, such as a .

• Headache that can not relieved
• Dizzeness
• Shortness of breath
• Loss of apptetite and vomiting or nausea
• Fatigue or lethargy
• Poor sleeping

this is an indication that you are not adapting to the altitude and should descend to the last elevation that you felt “well.” Treatments such as ibuprofen or anti-emetics should not be relied upon for continued ascent.

Severe signs and symptoms of AMS

If a person suffering from moderate AMS ignores the symptoms and continues to climb to higher elevations, the condition can become severe, leading to complications such as HAPE and HACE. Symptoms can include severe Altered LOR, Poor coordination or ataxia and Poor overall impression (lassitude -unresponsiveness – life-threatening Someone with severe AMS will likely need evacuation from the mountain by stretcher or helicopter.

High Altitude Pulmonary Edema (HAPE)

HAPE can develop as a result of the lung arteries developing excessive pressure due to the low oxygen environment. This pressure causes a build-up of fluid around the lungs. Fluid accumulation in the alveoli and membranes of the lungs due to increased blood flow and pressure throughout the lungs. As a result, pulmonary function decreased as fluid accumulates.Respiration are inhibited by either a decreased area for gas exchange or by increased distance that oxygen must travel . HAPE sometimes misdiagnosed as pneumonia, or lung infection. Symptoms can include coughing up blood or mucus, abnormal lung sounds, extreme listlessness, difficulty breathing, lips turning blue, weakness, confusion and unresponsiveness. If HAPE is suspected, oxygen is often administered in conjunction with immediate evacuation to a medical facility.

High Altitude Cerebral Edema (HACE)

HACE is a dangerous condition that requires immediate medical treatment.As swelling in and around the base of the brain , the climber becomes increasingly confused, lethargic, and drowsy, incapable of walking and behaving strangely. Symptoms can include disorientation, confusion, hallucinations, irrational behavior, severe headache, sometimes accompanied by nausea and vomiting. HACE cannot be treated without immediate evacuation to a medical facility.

Treatment for Altitude sickness

The only true treatment for altitude sickness is descent- descent- descent 300 to 1000m.

• Hydration , rest and nutrition.
• Pressure breathing , this may also be good technique for prevention.
• Supplemental oxygen
• Consider diamox 250mg every 12 hrs.

What is Diamox?

Acetazolamide ( Diamox) is the most drug that prevents Acute Mountain Sickness. It’s often the first treatment doctors gives to somebody might suffer from mountain sickness. Indeed, often travelers use it as a prophylactic, taking it during the trek up Kilimanjaro to prevent Acute Mountain Sickness.
Note: It is prohibited to use for the people who are allergic to Sulphur because Diamox is a sulfa derivative, and some people do suffer from side effects, particularly a strange tingling sensation in their hands and feet.

How does it work?

Diamox works by acidifying the blood. This stimulates breathing, allowing a greater amount of oxygen to enter into the bloodstream. Always consult with your doctor before taking it to discuss the risks and benefits.
Diamox is brilliant – “As you ascend to higher altitudes, pressure decreases. The composition of air (21% Oxygen) remains constant but the number of O2 molecules inspired in each breath becomes less and less. The body reacts by increasing our breathing rate (ie hyperventilation) to try and get more O2. So far… easy to understand.
As we breathe faster, we exhale more and more CO2. the corresponding level of bicarbonate (used as a buffer by the body for CO2) remains constant. This causes our blood to become quite alkalinic – and bingo – onset of symptoms of Altitude Sickness.

Solution is get rid of that bicarbonate.

Diamox acts by instructing the kidneys to rapidly excrete that bicarbonate hence turning the blood acidic and compensates for the respiratory alkalosis. The rapid excretion of the bicarbonate is accomplished through more frequent urination and alleviation of symptoms.
Despite multiple mentions of the Internet that use of Diamox results in an increase in blood oxygenation, this is not true. Only way to do that is with an oxygen mask or Gamov bag.”

Tools used by our guides to diagnose AMS.

In daily health checks, Climbing Kilimanjaro guides use a pulse oximeter to measure climbers’ oxygen saturation and pulse rate.The oximeter clips onto the climber’s finger, and after a short wait a percentage figure is displayed. The procedure is painless, non-invasive and takes just a few seconds. It uses light wavelengths to determine the ratio of oxygenated haemoglobin to deoxygenated haemoglobin; in other words, how well your blood is absorbing oxygen. This is of course a very good indicator of how well the climber is adjusting to the lack of oxygen that he or she can take into the body at altitude.
At sea level the oximeter reading should be near to 100. The guide will note this baseline figure down. He will then continue to test each climber at least once a day and note down the results on a table.
The readings will decrease as the climber ascends – this is normal and expected. But it’s how far it drops that is the concern of the guide, who will use your oximeter score and combine it with the other diagnostic tools to arrive at an opinion as to how well the climber is faring. This data is used, along with any symptoms presented, to build up a picture of the climber’s situation. It is important to recognize the symptoms of altitude sickness, as prompt treatment is necessary to prevent the condition from worsening.

Oxygen

Every trek is equipped with oxygen . It is compulsory to have it ,But what we never do is to use it to help someone to ascend to the summit. The oxygen is there to help people to descend down the mountain in a safe way. So if the guide decides that you need oxygen, then you must realize that there will be no more climbing for you, and it’s time to descend down the slopes.

Vaccination and Immunization

When planning a trip to Tanzania, getting vaccinated is a crucial step in ensuring your health and safety while abroad. By scheduling an appointment with your local travel clinic or GP a month or two before your trip, you give yourself ample time to discuss and receive the necessary vaccinations. It’s important to keep in mind that some vaccines require multiple doses and may take time to become effective.

Yellow Fever is a mandatory vaccine for travelers entering Tanzania from countries that are considered high-risk for the disease. The vaccine is required to prevent the spread of the virus and protect the population of Tanzania from potential outbreaks. It’s important to note that the vaccine must be administered at least 10 days before your arrival in Tanzania to be considered valid.

While there are no other mandatory vaccines for Kilimanjaro climbers, it’s important to consider any additional areas you may be visiting before and after your climb. For example, if you plan to visit other regions in Tanzania or neighboring countries, additional vaccines may be recommended to prevent the spread of diseases like typhoid, hepatitis A and B, and rabies.
When deciding which vaccines to get, it’s important to discuss your travel itinerary with your healthcare provider. They can advise you on which vaccines are necessary based on your specific travel plans, medical history, and current health status. Additionally, some vaccines may not be suitable for certain individuals, such as pregnant women or those with compromised immune systems.

It’s also important to keep in mind that getting vaccinated is not a substitute for other preventive measures, such as practicing good hygiene, avoiding mosquito bites, and taking precautions against food and waterborne illnesses. It’s recommended to bring insect repellent, sunscreen, and any necessary medications, such as anti-diarrheal or anti-malaria medication, with you on your trip.

In conclusion, getting vaccinated before traveling to Tanzania is an essential step in ensuring your health and safety while abroad. By scheduling an appointment with your healthcare provider early, you give yourself ample time to receive any necessary vaccinations and allow any potential side-effects to subside before your journey. Remember to discuss your travel itinerary with your healthcare provider and take other preventive measures to protect yourself while abroad.

Acclimatization

Acclimatization is an essential process for those seeking to climb Mount Kilimanjaro. It refers to the body’s compensatory mechanisms to adjust to the low-oxygen, low-atmospheric pressure environment, and begins from the moment you start ascending the mountain.

As you ascend slowly, your body initiates certain mechanisms to adapt, such as producing more hemoglobin to carry oxygen, increasing erythropoietin production, lowering plasma volume, and enhancing kidney function. These changes are gradual and occur over time. Making routes with a good acclimatization protocol provides the safest and most successful hiking for climbers of Mount Kilimanjaro. Building in acclimatization days and rest days can increase the chances of adequate adaptation and reduce the incidence of mountain sickness. The “hike high, sleep low” approach is also recommended to help the body adjust to altitude changes.

Although some people seem to have no problem acclimatizing to high altitude, there are no tricks or hacks to speed up the process. However, the medication Diamox has been shown to enhance the body’s natural acclimatization processes and can help expedite the adaptation process.

It’s crucial to note that Mount Kilimanjaro has various routes with varying degrees of difficulty, duration, and acclimatization protocols. It’s essential to choose a route that allows enough time for your body to adapt to the changes in altitude gradually. The longer it takes to reach high altitude, the longer your body has to acclimatize, increasing your chances of summit success and overall safety.

Mount Kilimanjaro climbing safety

Climbing Mount Kilimanjaro is the most safe for 90%, but sometimes death might happen but very rare, the founder of Rashad Adventure with over ten years of experience and climbing over 100 times witnessed only three death, in case you might have decided to book your climb with the company using unexperienced guides without WILDERNESS FIRST RESPONDER (-WFR ) then you are at high risk. Altitude Mountain Sickness (AMS) is the primary cause of fatalities,also the choice of the route for example Arrow glaciers has tendency of falling rocks and anyone attempting to climb the mountain is strongly advised to monitor and address any AMS symptoms.

It is essential for aspiring climbers to acknowledge the risks involved before attempting the climb, and receiving warnings is not meant to be a scare tactic. Although it is impossible to completely eliminate the hazards associated with high altitude climbing, following the advice of professional climbers can significantly reduce the risk.

Mountain rescue

If a climber becomes seriously ill or injured on Mount Kilimanjaro, a helicopter evacuation may be necessary. To ensure the safety of all climbers, there are multiple search and rescue companies that can provide emergency evacuation using high-altitude helicopters and trained medical personnel. These companies are based in Moshi, which allows for faster response times compared to past practices of deploying units from distant locations.

It’s important to note that adverse mountain weather may prevent helicopters from landing, requiring a manual evacuation via stretcher. The safety of climbers is the top priority, and further information on altitude sickness can be found in our comprehensive guide.

To ensure proper coverage for emergency evacuation and medical treatment, travel insurance that covers up to 6,000 meters above sea level is mandatory for all climbers. We will register a copy of your insurance details and passport with Kilimanjaro SAR when you book your climb, and they will work with your insurance company on your behalf. It’s important to carefully review your insurance policy to determine if pre-approval is required and whether you will be reimbursed. In case of an emergency, time is of the essence, and you don’t want to waste any valuable time seeking approval from your insurance company.
After evacuating a client , the next step is to transfer to the Hospital . There are good hospitals based in Moshi , for further treatment such as KCMC and Mawenzi, though can not be compared to the Western countries(Europe and America) Hospitals.
Flying doctors are also available.